Protect patients and Palo Alto

Sept. 26, 2018, 6:41 a.m.

A recent op-ed in these pages advocated for Measure F, the Palo Alto ballot initiative, by criticizing Cardinal Care, the university-sponsored health insurance option for students. But the only connection Measure F has to students is to substantially weaken the Palo Alto health care institutions that serve them.

Cardinal Care, the university-sponsored health insurance option, is a comprehensive plan that provides students with a national network of physicians and facilities for both medical and mental health needs. These benefits also apply to students traveling domestically and internationally. Cardinal Care was developed specifically with students’ needs in mind ― and is regularly reevaluated to maximize benefits for a relatively healthy, young adult population.

The authors of the op-ed assert that Measure F will make more care accessible to students covered by Cardinal Care. This assertion is significantly misleading.

The op-ed cherry picks details about coverage options and includes inaccurate descriptions of Cardinal Care and other aspects of health care at Stanford — including the impact of Measure F. In a new editorial titled “No, no, no on Measure F,” the Palo Alto Weekly called the measure a “wolf in sheep’s clothing” that “would do nothing to either improve patient care or reduce patient costs.” The Palo Alto City Council unanimously opposes this measure, and Mayor Liz Kniss appears in ads against the initiative. Given this strong opposition to Measure F, every one of us in the Stanford community should pause and take a closer look.

I’ve been a doctor for 17 years, and I’ve been with Stanford Health Care for the past four years. Like my colleagues, my top priority is delivering the highest quality of care possible for patients from the Stanford community and the surrounding area, as well as those patients who travel from far away to take advantage of Stanford’s specialized expertise. In fact, students covered by Cardinal Care have repeatedly asked that SHC become part of their in-network health providers.

When I took a closer look at Measure F, I grew deeply concerned that, if passed on Election Day, we would have to dramatically limit access to the services and care that our patients need.

We’re all interested in bending the cost curve of health care. This is what the ballot initiative purports to do — on the surface. But when you dive deeper, it becomes apparent that Measure F would have the opposite effect. Instead, it would deliver large payments to insurance companies in the form of rebates, without a requirement to pass those savings along to patients.

The consequences of Measure F are dangerous and would apply not only to large institutions like Stanford Health Care and Palo Alto Medical Foundation but also to many independent local providers, including dentists, optometrists and other specialists in our community.

If it passes, the measure would result in unsustainable budget cuts for us all. Many providers — including SHC — would be forced to reduce and potentially close certain services and programs, undermining our commitment to providing world-class care to the patients we serve. Ultimately, this measure would limit access to important medical services in Palo Alto.

Measure F also does not describe how Palo Alto could realistically enforce this new regulation. City government would be required to create entirely new departments to regulate the health care industry and manage expenses for all providers, for which they are ill-equipped and have no expertise. Palo Alto would be forced to make cuts to manage this process, pulling resources away from vital city services.

The lack of any logical, equitable and feasible mechanism within the initiative begs the question of how serious the measure’s supporters really are about addressing health care costs and quality.

— Megan Mahoney, MD, Chief of General Primary Care, Division of Primary Care and Population Health, Stanford Health Care

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